Customer Intake Form

Full Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Preferred Contact Method

Other

Emergency Contact Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Type of Service Needed

Preferred Appointment Date and Time

Date

Hour MinutesAM/PM Option

Budget Range

How did you hear about us?

Additional Notes

Waivers and Liability Agreements will be added here.

Client Name (Agreement)

Service Agreement — Detailing Services1. Pre-existing Conditions: Customer acknowledges that pre-existing scratches, dents, rock chips, paint defects, stains, interior wear, odors, and other prior vehicle condition issues not caused by the service are excluded from any workmanship warranty and may limit the achievable results.2. Ceramic Coating Disclaimer: When applicable, ceramic coating performance depends on proper maintenance, environmental exposure, and adherence to aftercare instructions. Ceramic coatings are not a lifetime guarantee unless expressly stated in writing; expected durability and performance will vary based on use, care, and conditions.3. Weather and Environmental Disclaimer (Mobile Services): Mobile detailing results and scheduling may be affected by rain, wind, extreme sun exposure, pollen, dust, and other environmental conditions. The provider may postpone or adjust services when weather or environmental factors could compromise results or safety.4. Mobile Service Requirements: For mobile services, customer must provide safe and lawful access to the vehicle and, when required and not otherwise arranged, access to potable water and a standard electrical outlet. The provider is not responsible for delays or incomplete work if safe access or required utilities are not available.5. Payment Terms: Payment is due upon completion of services unless otherwise agreed in writing prior to service. Accepted payment methods and any deposits will be noted separately.6. Cancellation and Rescheduling: Cancellations or rescheduling should be made as soon as possible. The provider reserves the right to apply cancellation or rebooking fees if notice is not given within the agreed timeframe or if travel or scheduling commitments were incurred.Deposit Policy: A non-refundable $75 deposit is required to secure all appointments and will be applied toward the final service total. Appointments are not confirmed until the required deposit is received. Cancellations or no-shows may result in forfeiture of the deposit.By signing below, the customer confirms they have reviewed this Service Agreement, understand the terms above, and authorize the provider to perform the requested services.

Client Name (Waiver)

Waiver of Liability — Detailing Services1. Acknowledgment of Pre-existing Conditions: Customer acknowledges and accepts that scratches, dents, rock chips, paint defects, stains, interior wear, odors, and other pre-existing conditions not caused by the provider are not the responsibility of the provider and may be unchanged or only partially improved by detailing services.2. Risk of Damage and Limitations: While the provider takes care to avoid damage, detailing processes may carry risks to paint, trim, soft tops, decals, vinyl, glass coatings, or interior materials. The customer accepts these inherent risks and agrees the provider will not be liable for pre-existing issues or for incidental, indirect, or consequential damages except in cases of gross negligence or willful misconduct.3. Ceramic Coating and Aftercare: Any ceramic coating applied requires proper maintenance to achieve advertised performance; the provider does not guarantee indefinite protection or performance unless specifically and expressly guaranteed in writing.4. Weather and Environmental Factors: Customer understands mobile services may be impacted by weather or environmental factors (rain, wind, pollen, dust, sun exposure). The provider may stop or postpone work to prevent unsafe or poor-quality results.5. Mobile Service Access and Utilities: Customer is responsible for providing safe access to the vehicle and, unless otherwise arranged, access to water and electricity when required. The provider is not responsible for delays or incomplete work due to lack of access or utilities.6. Payment and Cancellation: Customer agrees to pay the stated service fees upon completion unless prior written arrangements have been made. The provider reserves the right to charge cancellation or rescheduling fees under its policy.By signing below, the customer waives and releases the provider from liability for claims related to pre-existing conditions and accepts the terms stated in this Waiver of Liability.

Review: Service Agreement

Please review the Service Agreement above and confirm you understand the terms.

Client E-Signature

Signature Date

Date

Business Name

Business Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Authorized Signatory

Service Details

My Products

Deposit fee

A non-refundable deposit is required to lock in your appointment. Deposit goes toward your total service. Reschedules require 24-hour notice to transfer deposit. No-shows or late cancellations forfeit deposit.

Free Quantity

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Customer Intake Form

Review: Service Agreement

Review: Waiver of Liability

My Products*

My Products